Archive for month: December, 2018

SATURDAY, Dec. 15, 2018 (HealthDay News) — Winter can be hard on your skin, but you can take steps to keep it soft and supple, dermatologists say.
“When the weather changes, your skin care products should, too. For most of us, dry skin makes an appearance in the winter due to changes in temperature and humidity, so you need to think about appropriate skin care formulations,” said Dr. Rajani Katta. She’s a clinical professor of dermatology with the University of Texas Health Science Center at Houston.
Katta and her colleague, Dr. Megan Rogge, an assistant professor of dermatology at the university, offered these tips to protect your skin:
Choose thick skin creams over watery lotions. “Lotions are the least moisturizing, because they have such a high quantity of water. Creams are a better choice for those with dry skin,” Katta said in a university news release.
Use sunblock. Rogge explained that “even when the temperature drops, the sun’s rays can still emit powerful ultraviolet radiation. If you’re close to snow or water, those UV rays can be even more potent due to the reflective surfaces, which makes wearing protection paramount.”
Don’t take long, hot showers. “Many of us love to linger longer in steaming hot showers, particularly when it’s cold outside. These feel great, especially when your skin is itchy,” Rogge added. “But this can actually damage your skin barrier, and also exacerbate dry, itchy skin. That’s why it’s recommended to limit showers to 10 minutes, and use lukewarm water instead of hot water.”
Soak and smear to help lock moisture into your skin. Katta said, “After soaking your skin, you want to smear on your moisturizer. In other words, after you take a shower, you’ll step out of the shower, pat dry just a little bit, then apply a moisturizer while your skin is still damp.”
Wear gloves. “An important part of looking after your skin is using the right protective gear,” Katta noted. “Gloves keep your fingers warm and protect them, too.”
Use a humidifier in your home. According to Rogge, “Winter dry skin gets worse once you start turning on the heat in your home. That heat starts to dry the air in your home, which in turn starts to dry your skin. A humidifier in your bedroom when you sleep can really help.”
More information
The U.S. National Institutes of Health has more on keeping your skin healthy.

FRIDAY, Dec. 14, 2018 (HealthDay News) — As many as 20 million Americans have gallstones. Most don’t have any symptoms, but not all will escape a gallstone attack.
The gallbladder is a small organ in the upper right abdomen. It’s a reservoir for bile, the fluid made by the liver to aid digestion. Experts aren’t sure why, but gallstones form from imbalances in the substances that make up bile, such as cholesterol. You can have one or hundreds of gallstones, and they can be as small as a grain of sand or the size of a golf ball.
Gallstones: Who’s Most at Risk:
Women.
Anyone age 40 and older.
Anyone with a family history of gallstones.
Native Americans.
Mexican Americans.
“Silent” gallstones don’t interfere with the function of the gallbladder, liver or nearby pancreas. Often they’re discovered during an imaging test for another health concern.
If a gallstone blocks any of the ducts that connect the gallbladder to the liver or pancreas, you can suffer a gallbladder attack. It often happens at night, after a heavy meal, and the pain can last for several hours. The attack usually stops when the stone moves. But if the duct remains blocked, you risk complications such as inflammation or infection. Untreated blockages can be fatal if they stop the pancreas from working normally.
The good news is that serious gallbladder attacks affect only about 8 percent of people with stones, according to a Danish study. Most at risk are women in general and people who have one large stone or multiple stones.
Whether or not you know you have gallstones, know the signs of a potentially serious gallstone event and contact your doctor even if the pain goes away.
Warning Signs of Gallstone-Related Infection or Inflammation:
Abdominal pain lasting more than 5 hours.
Fever or chills.
Jaundice, the yellowing of the skin or whites of the eyes.
Nausea and vomiting.
Tea-colored urine and light-colored stools.
If tests confirm stones, you may want — or need — to have your gallbladder removed, a very common operation. And because the gallbladder isn’t essential, you can live normally without it.
More information
Read more about gallstones at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

THURSDAY, Dec. 13, 2018 (HealthDay News) — The future of medicine may be here: Researchers at the Massachusetts Institute of Technology say they’ve developed an ingestible capsule that can be monitored outside the body for health data, using Bluetooth wireless technology.
The capsule could deliver drugs as well as sense the condition of its surroundings in the gut, including infections or allergic reactions, the researchers explained.
Once these health conditions were spotted, one of these so-called “gastric resident platform” devices could release the proper medicine in response.
The goal is “customized ingestible electronics where the gastric residence period can be tailored, based on a specific medical application,” study lead author Yong Lin Kong explained in an MIT news release. He’s a former MIT postdoc researcher who’s now assistant professor at the University of Utah.
Kong said the 3D-printed capsule could someday become “a personalized diagnostic and treatment that is widely accessible.”
The device is ingested in a standard lozenge form like a pill. But sensory arms pop open once it’s inside the gut, revealing a Y-shaped device.
One of the arms contains compartments large enough to hold medicines that could be time-released over several days, the researchers said.
At the same time, the device’s sensors could monitor everything from heart rate to breathing levels and body temperature. Data might even be sent to a nearby smartphone, the MIT team noted.
The data would stay within about an arm’s length range, Kong noted. That’s a security feature, limiting “unwanted connections” to the data and “providing a physical isolation for additional security and privacy protection.”
The capsule is right now powered by a tiny battery, but in the future it might be powered remotely or even by harnessing energy from nearby stomach acid, the scientists added.
Testing is already underway in pigs, and human trials are anticipated within two years.
One gastroenterology specialist was enthused about the technology.
“Sometimes truth is more fascinating than science fiction,” said Dr. David Robbins, who helps direct endoscopy at Lenox Hill Hospital in New York City. “The long fantasized dream — that we could ingest micro-robots to battle whatever ails us — just got a few steps closer to reality with this report,” he said.
The device “can not only withstand weeks of submersion in pools of corrosive stomach acid but also deliver precise doses of medication — all controlled from a smartphone,” Robbins said.
He believes the potential of the new device could be limitless.
“It won’t be long before we can direct not only drug delivery but also micro-surgery in the gastrointestinal tract — no skin incisions, needles or even trips to the hospital required,” Robbins said.
For their part, the MIT team believes the technology has multiple uses. For example, it could release medicines as needed for people on strict drug regimens, such as people with HIV. Or it could give early warning of infection in people at high risk — patients on chemotherapy or immunosuppressive drugs, for instance.
The new research was funded by the Bill and Melinda Gates Foundation and the U.S. National Institutes of Health. The research team has also launched a company to help develop the technology.
The findings were published Dec. 13 in Advanced Materials Technologies.
More information
There’s more on the gastrointestinal system at the American College of Gastroenterology.

WEDNESDAY, Dec. 12, 2018 (HealthDay News) — For many obese people, weight loss surgery can be a new lease on life, but too few who qualify for the procedure opt for it.
One big reason: The widespread notion that surgery is an “easy way out,” signifying a weakness of willpower to slim down using diet and exercise.
Almost 40 percent of nearly a thousand surveyed in a new study thought weight loss surgery (or “bariatric surgery”) was this kind of lazy, quick fix for weight loss.
And a “large percentage of the population — nearly 50 percent — think that weight loss surgery is performed for mostly cosmetic reasons,” added lead researcher Dr. Heather Yeo. She’s an assistant professor of surgery at Weill Cornell Medical College in New York City.
That’s “unfortunate, as there are clear health implications to obesity, and strong data which support the effectiveness and safety of weight loss surgery,” she said.
Yeo believes people need to become aware of the health dangers linked with obesity.
“Obesity is a public health epidemic that contributes to mortality and many other health conditions, such as hypertension and diabetes,” Yeo said. “Weight loss surgery has a low rate of complications and also has excellent success.”
The patients who want weight loss surgery are not doing it to look better, agreed Dr. Eric DeMaria, president of the American Society for Metabolic and Bariatric Surgery.
Mostly, “they want better health,” he said. “The effective treatment for this disease of obesity is bariatric surgery, and 99 percent of the people who could benefit by this treatment aren’t getting it.”
But given the stigma around obesity, many patients don’t consider weight loss surgery, DeMaria noted. “You’re almost admitting to being a personal failure as a human being, because you can’t lose weight by yourself,” he said.
But that’s a false perception, DeMaria said. Obesity is a complex disease of metabolism. “It’s extremely difficult to treat without assistance of medications or surgery in addition to all the behavioral stuff,” he explained.
DeMaria said the surgery is safe and effective. In addition, he noted, “It also treats all the serious medical conditions that accompany obesity and even reverses the risk of premature death.”
For the study, Yeo and colleagues asked 948 people throughout the United States about their attitudes on obesity and weight loss surgery.
The researchers did find that women were less likely to think the surgery was cosmetic, and more likely to believe it was done for health reasons and not an easy way out.
The stigma of obesity is also shared by insurance companies, said Dr. Mitchell Roslin, chief of bariatric surgery at Northern Westchester Hospital in Mount Kisco, N.Y.
“We are not operating on patients that we potentially could show the greatest benefit because the insurance process is so rigorous and blames the patient,” he said.
But this is just an extension of society’s view that people choose to be obese, Roslin added. “People don’t understand that obese people don’t eat more to become obese, they eat more because they are obese,” he explained. “They have a regulatory disorder, and we blame them for their disease.”
Obese people should stop blaming themselves and choose treatments that work, like weight loss surgery, Roslin said.
The report was published online Dec. 12 as a research letter in the journal JAMA Surgery.
More information
For more on weight loss surgery, visit the American Society for Metabolic and Bariatric Surgery.

WEDNESDAY, Dec. 12, 2018 (HealthDay News) — Nearly 28 million Americans are affected by the skin condition eczema, and for some it may become so chronic and severe they consider suicide, new research shows.
A new review of data from 15 studies, involving over 300,000 people, found that those with eczema had a 44 percent higher risk of suicidal thoughts compared with people without the immunological disease.
People with eczema also had a 36 percent higher rate of suicide attempts, the study found.
Eczema, clinically known as atopic dermatitis, often brings a “profound psychosocial burden” to patients, concluded a team led by Dr. April Armstrong, of the University of South California (USC) Keck School of Medicine, Los Angeles.
Eczema is an inflammatory skin condition that often involves painful itch, blisters and sores. People can also have trouble sleeping due to itchiness and other symptoms.
The disease can vary in severity and can be socially debilitating, prior research has shown. One such study involved 600 eczema patients interviewed by researchers at Northwestern University in Chicago.
That study found that even for people with mild eczema, nearly 18 percent said they avoided socializing because of their appearance, while 23 percent said they limited their daily activities. Those figures rose to 40 percent and 43 percent, respectively, when moderate and severe patients were included.
The findings were published in July in the Annals of Allergy, Asthma and Immunology.
In the new study, the USC team found similar issues plaguing eczema patients.
“Because of the visibility of the disease, patients may experience shame, embarrassment and stigmatization,” Armstrong’s team said. This can affect a child’s performance at school or an adult’s ability to thrive in the workforce, they explained.
To learn more, the investigators analyzed data from 15 studies on eczema’s emotional toll on patients.
The findings showed that “patients with atopic dermatitis are at significantly greater risk of suicidal ideation and suicide attempts,” and the level of distress rose along with the severity of the skin disease, according to the report.
For example, while less than one percent of people with mild eczema said they had suicidal thoughts, that number rose to nearly 20 percent for those with severe disease, the researchers found.
Two skin specialists weren’t surprised by the findings.
Eczema “can be mentally stressful for patients who suffer from it,” said Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. She believes the study reinforces the need for treatments that minimize the illness, to help patients mentally cope.
Dr. Raman Madan practices dermatology at Northwell Health’s Huntington Hospital in Huntington, N.Y. He said that people with eczema often have to deal with concurrent health issues — conditions such as asthma, allergic rhinitis (hay fever), metabolic syndrome and sleep disturbances.
Now, the new study “casts light that dermatologists should screen for mental health in [these] patients,” as well, Madan said.
For their part, Armstrong’s team stressed that treatments that ease eczema severity are available.
Immune-targeted treatments, “such as interleukin 4 and interleukin 13, have been shown to decrease symptoms of depression and anxiety in patients,” the study authors wrote. And as physical symptoms subside, and the social stigma around the illness eases, “we can work toward reducing suicidality in patients with [eczema],” the team noted.
The new findings were published online Dec. 12 in JAMA Dermatology.
More information
For more on eczema, visit the U.S. National Institute of Allergy and Infectious Diseases.

TUESDAY, Dec. 11, 2018 (HealthDay News) — The bites of insects, spiders and dogs are a $1 billion yearly drain on the U.S. health care system, a new study has calculated.
And climate change is only going to make matters worse, researchers contend.
Attacks by mountain lions, bears and alligators get the most press, but the tiniest critters create the most work for emergency room doctors. Bug bites and stings account for more than half of all animal-related trips to the ER, the study authors discovered.
Bites from ticks, mosquitoes, fleas and spiders caused 41 percent of animal-related injuries, while another 13 percent of ER visits were prompted by a hornet, wasp or bee sting.
“As climate change occurs, their habitat will increase,” said lead researcher Dr. Joseph Forrester, a trauma/critical care fellow at Stanford University in California. “We’ve already seen that with tick populations and mosquito populations. We would anticipate over time more people in traditionally temperate climates will be exposed.”
For the study, Forrester and his colleagues reviewed five years of data to examine the extent and cost of animal-related injuries that are treated by emergency doctors.
Between 2010 and 2014, nearly 6.5 million people wound up in an emergency department as a result of injuries sustained from creatures great and small.
Beside insects, dogs were the next most common cause of injury, with canine bites accounting for 1 in 4 animal-related ER visits.
Only 3 percent of people needed hospitalization due to an animal wound, with bites from insects and spiders accounting for a quarter of those admissions.
Many of these hospitalizations likely were due to allergic reactions to insect venom, said Dr. Jennifer Stankus, an emergency physician with Madigan Army Medical Center in Tacoma, Wash.
“The No. 1 cause for death in the back country is an allergic reaction,” said Stankus, who wasn’t involved with the study. “It’s funny to me how such a small little creature can take you down, but they can.”
Another quarter of hospitalizations were due to bites from venomous snakes or lizards, which can be costly to treat, Stankus said.
“If you are bitten by a rattlesnake, it requires an anti-venom, and often it requires multiple vials. Each of those vials is $10,000,” Stankus said.
Only 1,162 patients in the study — 0.02 percent — died from their injury. Bites accounted for the highest rates of death, by rat (6.5 deaths per 100,000 bites), venomous snake/lizard (6.4/100,000 bites), or dog (6.1/100,000 bites).
During the five-year period studied, treating animal-related injuries cost $5.96 billion, or about $1.2 billion per year. This figure is likely an underestimate, researchers said, because it doesn’t include doctors’ fees, outpatient clinic charges, lost productivity or rehabilitation.
“We’ve seen our numbers in the emergency department go up as access to primary care physicians goes down,” Stankus said. “Where in the past people would go in on a same-day basis for a wasp sting or a minor dog bite, we now see those cases because people can’t get in to see their primary care doctor.”
Dog bites, nonvenomous insect and spider bites, and bites from venomous snakes and lizards accounted for 60 percent of the total costs.
The study findings were published Dec. 11 in the journal Trauma Surgery and Acute Care Open.
Many bites associated with large animals and snakes can be avoided with a little common sense, Stankus said.
“The demographics for a rattlesnake bite is a late-teen/early 20s male having consumed alcohol, on the right index finger,” Stankus said. “It’s typically because a human is antagonizing or messing with that animal.”
Dog bites can be avoided by never leaving children unsupervised around dogs, Forrester said. People should not approach unfamiliar dogs, or disturb a dog that is eating, sleeping or caring for puppies.
People can avoid insect bites by using insect repellent, wearing long-sleeved shirts and pants to cover exposed skin, and avoiding areas where insects nest, the American College of Emergency Physicians says. These include stagnant pools of water, garbage cans, and places where flowers are in bloom.
More information
The American College of Emergency Physicians has more about animal bites and stings.

TUESDAY, Dec. 11, 2018 (HealthDay News) — You’d think vitamin deficiencies would be rare in the United States, but many people are running low on vitamin D, and it’s a serious health threat.
Being short on vitamin D not only affects bone density, it’s also been linked to conditions such as heart disease, mental decline, some types of cancer, autoimmune diseases, infectious diseases and type 2 diabetes.
The problem is twofold: Not knowing how much vitamin D you really need, and how to get it. While 600 to 800 International Units (IUs) is the recommended daily amount, it can take more than that to bring you up to a healthy level and maintain it once you have a deficit.
The body can make vitamin D through sun exposure, but there are many variables, from time of day and the season to your location and your skin color. People with pale skin make vitamin D more quickly than those with darker skin. While there is concern about skin cancer risk, under the right conditions, exposing arms and legs (and your torso when possible) for only a few minutes two to three times a week allows the skin to produce enough vitamin D.
Very few foods naturally contain D. Many others are fortified with it, but it’s usually only 100 IUs per serving, making it unlikely that you’ll get even the daily minimum just from diet. An effective strategy may be a combination approach — sensible sun exposure, fortified foods and a supplement.
Talk to your doctor about getting the simple blood test that measures your level of vitamin D and the best way to get to — and stay in — the desired range, if necessary.
More information
Find out more about the importance of vitamin D from the U.S. National Institutes of Health.

MONDAY, Dec. 10, 2018 (HealthDay News) — In a feat that might help pave the way to restoring hair on patients with skin wounds from burns, injuries or surgery, scientists report regrowing hair on damaged skin in mice.
In their experiments with the rodents, the researchers found that activating what’s called the sonic hedgehog cell signaling pathway triggered communication between cells called fibroblasts.
These cells secrete collagen, a protein that plays a major role in maintaining the shape and strength of skin and hair.
The sonic hedgehog pathway is very active during the early stages of growth in the womb, when hair follicles are formed, but is not active in wounded skin in adults. This may be why hair follicles don’t grow in damaged skin, the researchers said.
“Our results show that stimulating fibroblasts through the sonic hedgehog pathway can trigger hair growth not previously seen in wound healing,” said study senior investigator Mayumi Ito. She’s an associate professor in the department of dermatology at NYU Langone Health in New York City.
However, animal research frequently doesn’t pan out in humans.
It had been believed that as part of the healing process, scarring and collagen buildup in damaged skin prevented hair regrowth.
“Now we know that it’s a signaling issue in cells that are very active as we develop in the womb, but less so in mature skin cells as we age,” Ito said in an NYU news release.
The team said it will continue its research in an effort to identify possible drug targets for hair regrowth.
The study was published recently in the journal Nature Communications.
More information
The American Academy of Dermatology offers advice on wound care.

MONDAY, Dec. 10, 2018 (HealthDay News) — Electronic health records are supposed to help doctors, but stress from using them may lead to burnout — and primary care doctors are at greatest risk, new research suggests.
“You don’t want your doctor to be burned out or frustrated by the technology that stands between you and them,” said study author Dr. Rebekah Gardner. She’s an associate professor of medicine at Brown University’s Warren Alpert Medical School in Providence, R.I.
“In this paper, we show that EHR [electronic health record] stress is associated with burnout, even after controlling for a lot of different demographic and practice characteristics,” she added in a university news release.
In the study, Gardner’s team analyzed the responses of nearly 1,800 doctors in Rhode Island who took part in a state health department survey about health information technology-related stress.
Of the 91 percent who reported using EHRs, 70 percent reported at least one measure of EHR-related stress. Those measures included frustration with using EHRs, spending time on EHRs while at home, and not having enough time for documentation while at work.
Doctors who didn’t have enough time for documentation while at work were 2.8 times more likely to have burnout symptoms than those without that pressure. The other two measures were associated with about a two-times higher risk of burnout symptoms.
The researchers also found that all three measures were reported by more than one-third of dermatologists (36 percent) and primary care doctors, including general internists (40 percent), family medicine physicians (37 percent) and pediatricians (34 percent). Nearly 31 percent of hospital medicine specialists reported all three measures.
Meanwhile, less than 10 percent of anesthesiologists and radiologists reported all three measures, according to the study.
The findings are “a signal to health care organizations that if they’re going to ‘fix’ burnout, one solution is not going to work for all physicians in their organization,” Gardner said.
“They need to look at the physicians by specialty and make sure that if they are looking for a technology-related solution, then that’s really the problem in their group,” she concluded.
The study was published Dec. 5 in the Journal of the American Medical Informatics Association.
More information
The U.S. Agency for Healthcare Research and Quality has more on doctor burnout.

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